If you have moderate or severe symptoms of fibroids, surgery may be the best treatment for you.
Surgical treatment can be a major procedure or a minor one. The type of surgery depends on the size, location, and number of fibroids present, and your desire to bear children in the future. Sometimes, there are a variety of surgical options to choose from. Talk to your health care provider about the different types of surgical treatments and about the possible risks, side effects, and recovery time of each procedure.
The current surgical treatments for fibroids are listed below.1,2,3,4
Endometrial ablation (pronounced en-doh-MEE-tree-ul ah-BLAY-shun) destroys the lining of the uterus. It is used to treat small fibroids inside the uterus. Two common ways of doing an ablation are with a heated balloon, and with a tool that uses microwave energy to destroy the uterine lining and fibroids.
Pregnancy is unlikely after this procedure, but it can happen. Women who get pregnant after endometrial ablation are at higher risk for miscarriage and other problems. If you are going to have this treatment, talk to your health care provider about the risks of getting pregnant after the procedure. You might want to use birth control to prevent pregnancy until after you go through menopause.5,6
This procedure removes only the fibroids and leaves the healthy areas of the uterus intact. It can preserve your ability to get pregnant.
Myomectomy can be performed in one of three ways. The method you need will depend on the location and size of your fibroids.
Studies show that myomectomy can relieve fibroid-related symptoms in 80% to 90% percent of patients.2 The original fibroids do not regrow after surgery, but new fibroids may develop.
Hysterectomy is the only sure way to cure uterine fibroids completely. Health care providers usually recommend this option if your fibroids are large, you have very heavy bleeding, and you are near or past menopause.
During a hysterectomy, the whole uterus or just part of it is removed. The types of hysterectomy include:
Figure 2. Types of Hysterectomies. A subtotal hysterectomy involves removing the upper portion of the uterus above the cervix. In a total hysterectomy, the surgeon removes the entire uterus, including the cervix. A radical hysterectomy includes the complete removal of the uterus, cervix, upper vagina, and surrounding tissue.
There are several approaches to doing a hysterectomy:
If you have not gone through menopause and are considering a hysterectomy for your fibroids, talk to your health care provider about keeping your ovaries. The ovaries make hormones that help maintain bone density and sexual health even if the uterus is removed. If your body can continue to make these hormones on its own, you might not need hormone replacement after the hysterectomy.
Having a hysterectomy means that you will no longer be able to get pregnant. Talk to your partner or spouse before deciding to have a hysterectomy. This process cannot be reversed, so be certain about your choice before having the surgery.
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